Evaluation of white matter integrity by diffusion tensor imaging in the deficiencies of vitamin B12 and folate in older patients.

This article investigates the impact of vitamin B12 and folate deficiencies on white matter (WM) integrity in older adults using Diffusion Tensor Imaging (DTI), a noninvasive MRI technique sensitive to microstructural brain changes. The study included patients aged 65 and older, analyzing DTI parameters—fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD)—across various WM tracts relative to serum vitamin B12 and folate levels, with deficiency thresholds set at <200 and <400 pg/ml for B12, and <3 and <6 ng/ml for folate. Results showed that even at higher laboratory cut-offs (<400 pg/ml for B12 and <6 ng/ml for folate), deficiencies were associated with impaired WM integrity in regions including the corpus callosum, cingulum, superior longitudinal fasciculus, and cerebellar peduncles. The findings suggest that DTI can detect early microstructural WM deterioration linked to these micronutrient deficiencies in the elderly, highlighting the importance of monitoring and treating vitamin B12 and folate levels to potentially prevent neurodegenerative consequences.